RESUMO
The present study was performed to find out the prescribing patterns of the doctors for geriatric patients, to characterize the behavior of the outdoor geriatric patients of a selected private hospital and to investigate whether polypharmacy is a suitable indicator for occurrence of unnecessary or irrational drug therapy. A prospective study was carried out with the help of a structured questionnaire and the prescriptions of the patients. Patients aged 65 year and above were included in the study. A total of 35 patients were interviewed and their prescriptions were collected after taking their consent. Among the patients, hypertension was found to be most prevalent (46%) followed by diabetes mellitus (16%). Chief complaints were chest pain (41%), joint pain (37%), muscle pain (34%) and respiratory distress (27%). About 34% of the patients did not comply with the prescription and 75% did not take regular physical exercise. Stress (49%) and insomnia (41%) were common among the patients. Polypharmacy was observed in 69% of the patients and an average of 5.5 drugs was given to them. Losartan potassium was the mostly prescribed (31%) drugs followed by esomeprazole (20%) and multivitamins (17%). Unnecessary drug use problem can be prevented by the rational prescribing of drugs by the practitioners. Any medications without therapeutic benefit, goal or indication should be avoided during prescribing for geriatric patients. This study reveals the prescription trends, and indicates possible areas of improvement in prescribing practice.
RESUMO
Background: The information of the sensitivity pattern of the causative organisms is very important for effective control of septicemia in neonates. OBJECTIVE: To determine the proportion and profile of pathogenic bacteria in the blood cultures of the neonates with clinically suspected septicemia and their susceptibility pattern to antimicrobial agents for developing a unified antibiotic treatment protocol. Materials and Methods: A cross-sectional retrospective study was conducted over a period of 3 year and 4 months (39 months). The study included 1000 patients admitted in the selected hospital in Bangladesh. Blood samples for culture were taken aseptically before starting antibiotic therapy. Microorganisms were isolated and identified by standard microbiological processes which include colony morphology, Gram stain, and biochemical profiles. Antimicrobial sensitivity patterns were performed by Kirby-Bauer's disc diffusion method against imipenem, ciprofloxacin, ceftazidime, chloramphenicol, netilmicin, gentamicin, ceftriaxone, aztreonam, cefotaxime, cephalexin, and ampicillin. Results: Among the patients, 633 (63.3%) were males and 367 (36.7%) were females. Blood cultures were found positive in 194 (19.4%) neonates. The organisms isolated were Pseudomonas spp. (31.4%), Klebsiella pneumoniae (23.2%), Staphylococcus aureus (12.4%), Escherichia coli (7.2%), Acinatobactor (5.7%), Gram-negative Bacilli (4.1%), Flavobacterium spp. (3.6%), Serratia spp. (5.7%), Citrobacter fruendi (3.1%), Streptococcus species (2.6%), and Enterobacter spp. (1.0%). A majority of the bacterial isolates in neonatal sepsis were found sensitive to imipenem (91.8%) and ciprofloxacin (57.2%) and resistant to commonly used antibiotics, eg. ampicillin (96.4%) and cephalexin (89.2%). Conclusion : The problem can be mitigated by careful selection and prudent use of available antibiotics.